Effects of a Clinic-Based Conversation Skills Group Training Program on Children with High Functioning Autism/Asperger Syndrome

Background: One of the most powerful human abilities is the use of language in conversation as a means of relating to other humans.  Children diagnosed with High Functioning Autism/Asperger Syndrome (HFA/AS), however, often have difficulty conversing.  As a result, speech-language pathologists have developed and implemented clinic-based social skills groups. These training programs are designed to improve the conversation skills of children with HFA/AS.  Although clinicians intuitively perceive the benefits of social skills group training programs, there is inconclusive evidence to support clinical practice. 

Objectives: The objective of this study was to explore the effects of teaching conversation skills, namely appropriate initiations and responses, to children diagnosed with HFA/AS in an outpatient clinic-based group setting. This study included three research questions: 1) Is there a difference between pre and post clinic observation of participants’ initiations and responses during conversation after they participate in an outpatient clinic-based intervention group training program? 2) Is there a difference between pre and post clinic observation in the appropriateness of initiations and responses after participating in an outpatient clinic-based intervention group training program? 3) Is there a difference between pre and post clinic observation in the proportion of initiations and responses participants direct towards peers as compared to adults during conversation after completion of an outpatient clinic-based intervention group training program?

Methods: Seven boys between the ages of 8 and 10 years old participated in this study.  The boys attended a 6 week conversation skills group intervention program that met one time per week for 90 minutes.  This study utilized an observational design.  Prior to, immediately after and 6 weeks following the intervention, data regarding the children’s initiations, responses, appropriateness and partner (peer/adult) during conversation was collected in-clinic, as well as at participants’ schools.  Descriptive measures for this study included frequency counts, ratios, means and difference scores for each child. 

Results: Results from this study revealed an increase in the frequency of responses used in-clinic, as well as an increase in participants’ use of initiations at school at post observation. Little to no maintenance of the increase in initiations, noted at post observation, was observed at the 6 week follow-up observation.  No major trends, only slight increases and decreases, were noted both in-clinic and at school regarding appropriateness and to whom participants directed their initiations and responses to (peer/adult) during conversation.

Conclusions: The descriptive information acquired from this study suggests that for children with HFA/AS, small group direct instruction of initiations and responses during conversation in-clinic may be useful for increasing those behaviors, but only in the short-term. In addition, this study demonstrates the feasibility of recording and gathering observational data on elements of conversation in a natural environment such as school. Finally, the preliminary data from this study provides a target effect size and estimate of variability for designing more definitive intervention studies.